Provider Demographics
NPI:1215310347
Name:CHAIN, JOLIE (MPH)
Entity type:Individual
Prefix:MS
First Name:JOLIE
Middle Name:
Last Name:CHAIN
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 AMELIA ST
Mailing Address - Street 2:
Mailing Address - City:SUTTER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95685-9589
Mailing Address - Country:US
Mailing Address - Phone:310-741-7774
Mailing Address - Fax:
Practice Address - Street 1:125 AMELIA ST
Practice Address - Street 2:
Practice Address - City:SUTTER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95685-9589
Practice Address - Country:US
Practice Address - Phone:310-741-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health